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Want to invest in social prescribing? It's not all about the money.

May 2, 2019

    In two research studies this year, the Global Forum investigated the connection between health and non-health care services. As care providers, we are waking up to the impact that social determinants of health have on clinical outcomes. Accordingly, many health systems are now trying to figure out how to bridge that divide—and one of the most novel and interesting concepts to do so is social prescribing.

    Mind the gap: How to manage the rising-risk patient population

    Social prescribing's approach says, 'Since we know that services like affinity groups, fresh food vouchers, and transportation affect health care outcomes, let's prescribe them as we would a clinical treatment.' It's an approach that involves both diagnosing and funding those social services.

    When I describe this approach to members, they rightfully zero in on the same aspect: the money. 'They pay for that with health care funds?'

    The answer is yes, and they do so purposefully. Funding these services with health dollars represents both the understanding and commitment to achieving population health by addressing the root cause of patient instability—be it clinical or otherwise.

    Looking beyond money: How to effectively diagnose non-clinical needs

    As someone who spends a lot time looking how the money works in health care, I would never discount the importance of this shift. But I do worry that we get too preoccupied with the financial side of social prescribing, and forget another key aspect of what makes it work: the diagnosis.

    The best example of diagnosing non-clinical needs in a systematic and structured way comes from Voluntary Action Rotherham (VAR) in the U.K.

    VAR uses social prescribers to understand, assess, and prescribe social services to patients based on what's available in the community. These dedicated staff, through face-to-face interactions and repetition, serve as a nexus for a variety of social support services that we in health care are often unaware of. This connection is AS IMPORTANT as the money that follows the patient and pays for the service.

    The returns from this diagnosis and spending have been compelling: £650,000 in avoided health care costs and a 42% reduction in ED attendances for high-utilisers.

    Similar models are being trialed in in Canada, Sweden, and Australia. It's easy to see these as a few pilots, but I think this is more than that, and my team will watch with interest as more data from these initiatives are made public and small pilots turn into full-scale operations.

    For those interested at being the vanguard in their jurisdictions here, my advice is pretty simple: Place equal effort to the prescribing part as the paying part. They work in tandem.

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